Medical aspects of fitness to drive a guide for medical practitioners

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Medical aspects of fitness to drive A guide for medical practitioners Published July 2009 ISBN 978‐0‐478‐34609‐1 (print) ISBN 978‐0‐478‐34610‐7 (electronic) Copyright: July 2009 NZ Transport Agency If you have further queries, call our contact centre on 0800 822 422 ext 8089 or write to us: NZ Transport Agency Private Bag 11777 Palmerston North 4442. This publication is also available on the NZ Transport Agency’s website at www.nzta.govt.nz
Foreword The NZ Transport Agency and all those working in the health arena are well aware of the impact road crashes have on New Zealanders’ lives – the people injured, their caregivers, families of those killed, health professionals and emergency services workers who deal with the aftermath of a crash. We need to be confident, with so much at stake, that all the drivers on our roads are medically fit to control their vehicle, see other road users, make speed and distance judgements and react safely to a potentially hazardous situation. Medical practitioners cannot assume that the driver licensing system will pick up individuals who are unfit to drive, so it is important that you consider medical fitness to drive in your everyday dealings with patients, not just when someone wants a medical or eyesight certificate for driver licensing purposes. Except for older drivers, most drivers are issued licences for 10 years. For those who develop some types of medical conditions, this is ample time for their condition to deteriorate to a point where they are unfit to drive. Determining that someone is no longer fit to drive is a weighty responsibility, but the alternative is to allow them to continue to drive when they put their own and others’ lives at risk. Thankfully, health professionals are just as committed to road safety as we are. The relationship formed between the NZ Transport Agency and health professionals goes a long way towards ensuring that New Zealand’s roads are safe for all to enjoy. This document is intended to help you assess an individual’s fitness to drive. We acknowledge that we could never comprehensively cover all the medical conditions that might affect a person’s ability to drive – accordingly, this document is only a guide and should be treated as such. Geoff Dangerfield Chief Executive July 2009 NZ Transport Agency | Medical aspects of fitness to drive i
Page 1: Medical aspects Publication title o
Page 5 and 6: 10. Miscellaneous conditions 109 10
Page 7 and 8: 1. General matters This section cov
Page 9 and 10: The extent of the examination The e
Page 11 and 12: 1.5 Second opinions and dealing wit
Page 13 and 14: Medical condition Class 1 or class
Page 15 and 16: 2.2 Blackouts of unknown cause (exc
Page 17 and 18: Medical standards for individuals a
Page 19 and 20: neurologist’s report is provided
Page 21 and 22: 2.8 Dementia and other cognitive im
Page 23 and 24: 2.10 2.10.1 Structural intracranial
Page 25 and 26: Medical condition Class 1 or class
Page 27 and 28: 3.1.2 Angina pectoris (suspected) M
Page 29 and 30: 3.2 Severe hypertension Treatment f
Page 31 and 32: 3.3.4 Pacemaker 3.3.5 Automatic imp
Page 33 and 34: 3.5 Cardiac failure and cardiomyopa
Page 35 and 36: 3.9 Other cardiovascular disease 3.
Page 37 and 38: Factors for medical practitioners t
Page 39 and 40: 4.1 Type 1 diabetes Individuals in
Page 41 and 42: Introduction Specific neuromuscular
Page 43 and 44: 6. Visual standards Summary table T
Page 45 and 46: Dealing with individuals who are un
Page 47 and 48: 6.3 Visual fields For safe driving,
Page 49 and 50: 6.7 Night blindness Individuals who
Page 51 and 52: Introduction There is very little e
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Legal obligations on medical practi
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Psychotropic medication can tempora
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Factors for medical practitioners t
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Medical standards for individuals a
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When driving should cease Driving s
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Factors for medical practitioners t
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12. Driving after surgery The table
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14. Temporary driving impairments A
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Appendix 1. Section 18 of the Land
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Table B. Graduated driver licensing
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Appendix 6. Example letter for noti
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References American Optometric Asso
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